Obama's Health Care Summit: Just for Show?

Could this turn into something more than political theater? President Barack Obama's televised dialogue with Republican lawmakers on health care, promised for later this month, has the makings of an entertaining exchange. But the differences between the basic Democratic and GOP ideas are stark — and the two sides have increasingly hardened their positions in this election year.

Yet, in a story with more twists than a soap opera, Obama's invitation to congressional leaders of both parties to attend a Feb. 25 meeting can't be dismissed as a mere diversion. Although many Americans have doubts about the Democrats' sweeping plans to cover the uninsured, Republicans can't afford to be perceived as oblivious to the health care insecurities of middle-class families.

"My expectations? Probably below 50 percent, but not zero," said Rep. Gerry Connolly, D-Va., a moderate who serves as president of the Democratic freshman class. "At some point, the public is going to demand that Republicans participate like mature adults, and not just say 'no' to everything."

It's the Democrats' big-government approach — not Republicans — that's the problem, insisted Rep. Dave Camp, R-Mich., author of the House GOP bill. "The president has got to show that he has heard what the American people are saying. He's got to make clear we are not going to start off with the current bill."

But where to start?

— Democrats want an upfront commitment to cover most of the nearly 50 million uninsured Americans. Republicans prefer first taking steps to cut costs, then revisiting the issue of full coverage over time.

— Democrats would raise taxes to provide government subsidies for people who can't afford to buy health insurance. Republicans say now is not the time to increase taxes.

— Both sides want to bar insurance companies from turning down people with health problems, but only Democrats propose requiring most people to get coverage — a necessary first step, according to most experts.

To illustrate the gap, the House GOP bill would cover 3 million uninsured people, the House Democratic version 36 million.

"That's quite a gulf," said Rep. Steny Hoyer, D-Md., the No. 2 Democrat in the House. "And if that's where Republicans want to stay, I don't think it's going to be perceived as much progress by the 33 million who would be left out."

After months of seeing Obama try to muscle legislation through with only Democratic votes, Republicans are wary of his new overture. The election of Republican Scott Brown in Massachusetts changed the balance of power in the Senate, forcing the president to recalibrate.

"This has the feel of a campaign event," said economist Douglas Holtz-Eakin, a top adviser to 2008 GOP presidential candidate John McCain. "The time to sit down with Republicans was a year ago."

The House and Senate are partisan institutions by design, Holtz-Eakin said. Divided into majority and minority, they sharpen differences. Only Obama could have guaranteed a bipartisan health care bill. "You needed the White House to spend political capital telling the liberal base in the House they weren't going to get everything they wanted," he said. "They weren't able to do that."

The way the health care summit was announced struck some Republicans as suspect. Democrats say the idea came from the White House, and was first broached last Thursday when Obama met Speaker Nancy Pelosi, D-Calif., Senate Majority Leader Harry Reid, D-Nev., and Hoyer, to discuss the 2010 legislative agenda.

Republicans say they were notified by the White House on Sunday, a couple of hours before a CBS News interview in which Obama floated the proposal. Usually, White House schedulers call congressional leaders well in advance of major meetings.

Democrats say they want to resolve remaining differences between the House and Senate versions of their own legislation in advance of the meeting. That may mean Obama wants to emphasize contrasts with Republicans, not probe for common ground.

The meeting is expected to be held at Blair House, the presidential guest house across from the White House, but the administration has not released any details about the format. "I don't agree this is going to be political theater," said spokesman Reid Cherlin. "This is going to be a substantive discussion about how best to achieve the goals the president laid out."

Starting from scratch is not an option, Democrats say. But Republicans say they can't see the House and Senate Democratic bills as a beginning. For one thing, both would raise taxes.

House Republican leader John Boehner of Ohio wrote White House Chief of Staff Rahm Emanuel on Monday saying Republicans would "rightly be reluctant to participate" if the starting point is the Democratic legislation. Previously, Boehner welcomed Obama's offer. Asked if Boehner is now setting conditions, an aide would not elaborate.

Still, there are a couple of issues on which Obama could try to nudge both sides.

He could officially bury the government insurance plan sought by liberals. A major obstacle for Republicans, the public option never had the votes to pass in the Senate. Yet Obama has hesitated to declare it dead.

The president could also follow through with curbs on medical malpractice litigation. Although he agrees with Republicans that fear of lawsuits leads doctors to practice defensive medicine and drives up costs, Obama has not insisted that limits on litigation be in the bill.

Any step toward limits — fiercely opposed by the nation's trial lawyers — is certain to draw solid Democratic resistance in a midtern election year. It's unclear how much such a gesture by Obama would help at this point.

"Right now, it is hard to get people to move off positions that they have taken," said Gail Wilensky, who ran Medicare for former President George H.W. Bush. "It's not like there was a bipartisan effort that went to the 11th hour and then fell apart. It was a Democratic package."

Could this turn into something more than political theater? President Barack Obama's televised dialogue with Republican lawmakers on health care, promised for later this month, has the makings of an entertaining exchange. But the differences between the basic Democratic and...